Safe at Home XI: Who changes your diaper?

When you were young and helpless, it was mommy. When you are old and helpless, it will be a spouse, child or professional caregiver. We all become adults once and babies twice — in the beginning and at the end.

Unless you get hit by a bus or taken out by a massive heart attack, you have a 70 percent chance of needing long-term care after 65.

I gave little thought to this sobering stat until I started providing care to others. Each of my clients is in his or her mid-to-late 80s and some wear diapers. Until I started Home Haven, a service that provides in-home personal care with live-in caregivers, I gave no thought to who will change my diaper.

Changing a diaper from a clinical perspective is no big deal, nor is providing professional personal care. The big deal is the family dynamic. It can be fascinating, frustrating and a wonder to behold. In many ways, it the most difficult part of my job.

For example, look at my man Mo, the 88-year-old escapee from an assisted living institution in Sun City Center and the guy who motivated me to start Home Haven. Mo’s wife died, his only child was 1,500 miles away and unable to help, and his girlfriend at the institution was overwhelmed and walked away.

So when I found him lying in the parking lot of our condo in Kings Point, it was obvious Mo’s personal care would come from a paid professional. The family dynamic was non-existent. Sometimes that is beneficial.

Lillian, a 91-year-old matriarch with two loving daughters, is receiving care at her Sun City Center home. The youngest daughter, Karen, quit her job and moved in to take care of her mother full time. Karen, soon to be a Medicare recipient, needs care; her back hurts, she is exhausted, depressed and experiences shortness of breath when helping with strenuous tasks. Being her mother’s caregiver is killing her.

Lillian can be sweet one moment and a raging witch the next. She refuses to let anyone except her over-worked, under-appreciated daughter administer to her needs. Periodically, the family puts down its foot and threatens institutionalization unless Lillian allows professional paid in-home care.

Enter Home Haven. I spent a delightful 90 minutes laying out a plan to assist the family. Lillian was cooperative and adorable. The daughters were delighted. A nursing assistant would arrive the next day to take care of Lillian.

“Thanks so much,” Karen smiled as she escorted me to the door, “you’re a miracle worker.”

Less than 24 hours later, Karen was on the phone. “Mom is in a rage. She is throwing a tantrum. She refuses to cooperate.”

My suggestion that Lillian probably would cooperate once the professional caregiver took over was met with a tearful, “I just can’t do it to her, she’s my mom.”

Yes, I wanted to say, and it was your mom who dragged you kicking and screaming into the doctor’s office for your shots. She did it because she loved you. Now you must do what is best for her — and you.

I could have added that many spouses, sons and daughters suffer serious illnesses within three years of becoming family caregivers. I kept quiet because I understood the matriarch would rule the roost until the family dynamic ended in tragedy or Karen mustered enough courage to finally silence the mouse that roars.

I also have experienced a family dynamic that worked impressively.

Paula tried to take care of her bedridden 89-year-old husband. She quickly became overwhelmed providing part-time daily assistance. Her daughter flew in and, with a consensus from other siblings, quickly and efficiently resolved the problem: Dad must go to a nursing home or a 24/7 live-in care must be hired. The husband is now receiving care in their lovely Sun City Center home. A professional caregiver changes his diaper. Paula has returned to the routine more befitting of an 85-year-old great grandmother.

“Lead, follow or get out of the way” is a way of thinking that has served me well. Families who can define the proper role for each member make smoother transitions. Those who don’t suffer stress, turmoil and illness.

Jimmy Curtis is registered to provide homemaker and companion services with the State of Florida, Agency for Health Care Administration. He can be reached at jim.curtis1210@yahoo.com or 813-331-3471.